Provider Demographics
NPI:1649564675
Name:LYBARGER FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:LYBARGER FAMILY CHIROPRACTIC
Other - Org Name:DR. JAMES LYBARGER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:LYBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-603-0300
Mailing Address - Street 1:8861 SW COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223
Mailing Address - Country:US
Mailing Address - Phone:503-603-0300
Mailing Address - Fax:503-603-0302
Practice Address - Street 1:8861 SW COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223
Practice Address - Country:US
Practice Address - Phone:503-603-0300
Practice Address - Fax:503-603-0302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3925111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1598993073OtherNPI